How Does the Senate Healthcare Bill Affect Medicaid?

One of the issues holding up the progress of Republican healthcare legislation has been its potential impact on Medicaid, with moderate Republicans and Democrats wanting to keep Obamacare’s Medicaid expansion, and conservative Republicans looking to roll it back to the greatest extent possible.

Here’s how the Senate version of the healthcare bill as drafted will affect Medicaid:

It repeals the Obamacare Medicaid expansion by 2024, rather than the 2020 goal of the House bill.

It allows states to implement work requirements for Medicaid enrollees who are deemed able to work.

It allows states that create work requirements to kick able-bodied enrollees off of Medicaid if they are unemployed and not looking for or training for a new job. People under 18, pregnant women, single parents of children under the age of six, and people who are disabled would be exempt.

It caps Medicaid spending at an even lower rate than the House bill. We won’t know the exact estimate until the Congressional Budget Office publishes their review, but the House bill’s cuts were projected to reduce Medicaid by $830 billion over ten years.

Prior to the release of the Senate bill ten managed care organizations submitted a letter to Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Chuck Schumer (D-NY) opposing the steep cuts to Medicaid. They supported the idea of Medicaid reform and offered their assistance in formulating it, but they advocated strongly not to make policy changes that would adversely affect our "nation’s neediest citizens."

The groups decried the spending cap models proposed by the draft, which leave states to make up the difference through efficiencies that they maintain do not exist:

"There are no hidden efficiencies that states can use to address gaps of this magnitude without harming beneficiaries or imposing undue burden to our healthcare system and all U.S. taxpayers.”

Now-President Donald Trump tweeted something to that effect back in 2015:

The Republicans who want to cut SS & Medicaid are wrong. A robust economy will Make America Great Again! https://t.co/u25yI5T7E8

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This is a heartless bill. Who will define able bodied! Will someone with schizophrenia be considered able bodied? This is just like the GOP to assume that people are taking advantage of Medicaid. I have worked with the Medicaid population for 17 years and I have not seen that. People that are on Medicaid need to be on Medicaid. The GOP never wanted to ensure all people had access to health care. That was not their purpose or intent. The GOP has not talked to AARP, AHA, AMA or the ANA. This is not a plan, but a cut in spending so more money can be spent on bolstering defense spending, a huge pointless wall, and hiring more border patrol. This bill remains "mean" and in fact is "meaner" than the last version. Tell your peers across the aisle if they endorse this bill no one will forget their spitefulness and cruelty to the most vulnerable Americans.

This is not a healthcare bill, it is a tax cut for the wealthy. I teach special education to poor minority students, and I am terrified for their health. If the bill was ok then why were they hiding it. Just go back and look at the tweets from republicans when Obamacare was being dissected.

The republican heath plan will kill people while giving the wealthy more wealth. This is not the America I was raised to believe in. If you pass this some of your fellow Americans will die and all your conservative Christian beliefs will be lies.

The one year ban for Planned Parenthood is reason enough to make sure this bill never passes. Woman need to have the right to choose the health care provider that is both responsive to their needs and provide abortions, which remains legal. The GOP will demand proof of rape or life threatening medical records of which is none of their business. Whatever happened to their "it is between you and your physician" meme. That was removed from the GOP rhetoric when they decided to attack every woman's right to choose

We need a single payer system as healthcare should be every citizens right as it is in the rest of the civilized world. The conservative right is not reflecting the values of Christ. Show you're support for all Americans, not simply your party and the wealthy. Vote this farce of a bill down!!

If you make these cut to Medicaid you are leaving the most needy vulnerable and that is a disgrace. Also raising premiums on the older population does not even make sense since the baby boomers are all getting ready to retire and have a limited income, this would be a hardship. This population would then not be able to afford insurance. What are you people in government thinking? What you should be doing is not bowing down to the insurance companies and pharmaceutical companies!!!

Leave Medicaid alone. Rich Americans do not need a tax break. You should have included the AARP, the American Doctor Association, etc.to provide input to the health plan. President Obama did and you should too. These organizations are dealing with this issue daily.